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Publications
Intraoperative fascial traction (IFT) for the treatment of large ventral hernias.
IFT (intraoperative fascial traction) is a new procedure for abdominal wall stretching in large ventral hernias. The present study shows a high effectiveness of IFT with good clinical practicability and low complication rate.
Niebuhr, H., Malaibari, Z.O., Köckerling, F. et al. Intraoperative Faszientraktion (IFT) zur Behandlung großer ventraler Hernien. Chirurg (2021)
Is the dissection of the abdominal wall still necessary in the treatment of W3 hernias?
For the treatment of complex hernias, there are no internationally accepted evidence-based recommendations regarding the restoration of abdominal wall integrity. In this paper, we are reviewing the development of different component separations (CS) and other techniques used in treating such conditions. A literature review was carried out to describe some important techniques to treat giant hernias. After a detailed description of the CS and its important modifications, we are describing and discussing the relatively new fascial traction technique with its modification. With these reviews of the mentioned studies, we are questioning the extent to which the CS is still indicated in treating giant hernias and point out the importance of further comparison studies evaluating different techniques.
Henning C. Niebuhr, Halil Dag, Zaid Malaibari, Ferdinand Köckerling, Wolfgang Reinpold, Marius Helmedag
Case Report: Intraoperative Fascial Traction in Robotic Abdominal Wall Surgery; An Early Experience
Intraoperative fascial traction (IFT) may obviate the use of a posterior component separation/transversus abdominis release (TAR). Robotic abdominal wall surgery leads to a reduction of morbidity in TAR compared to open surgery. The combination of minimally invasive (robotic) abdominal wall surgery with IFT may lead to a further reduction of surgical morbidity.
Bloemendaal ALA (2022) Case Report: Intraoperative Fascial Traction in Robotic Abdominal Wall Surgery; An Early Experience. J. of Abdom. Wall Surg. 1:10356. doi: 10.3389/jaws.2022.10356
Vertical traction device prevents abdominal wall retraction and facilitates early primary fascial closure of septic and non‑septic open abdomen
Fung, S., Ashmawy, H., Krieglstein, C. et al., Langenbecks Arch Surg (2022)
Maintaining abdominal wall integrity: Closure of W3 hernias using standardised fascial stretching
Adequate management of very large abdominal wall/scar hernias has usually only been possible by some form of component separation. Intraoperative fascial stretching using fasciotens®Hernia is a promising new method for the treatment of complex ventral hernias that can preserve abdominal wall integrity.
Chirurgische Allgemeine – Offprint. Preservation of abdominal wall integrity. CHAZ 3_2021.
Intraoperative fascial traction as an alternative to component separation. A prospective observational study.
Prof. Niebuhr reports on an observational study of 21 patients in which complex hernias with a mean preoperative fascial distance of 17.3 cm (8.5-44 cm) could be effectively closed using the fasciotens method while avoiding component dissection. The mean stretch gain was 9.8 cm.
Complete abdominal closure using Fasciotens®Abdomen in a case of open abdomen following complex aortic surgery in a 16-year old male patient suffering from mid-aortic syndrome
Complete abdominal wall closure of open abdomen after complex aortic emergency reconstruction for “mid-aortic syndrome(MAS)” using fasciotens®Abdomen in the case of a 16-year-old patient.
Diskussion: MAS is a rare aortic pathology whose description is based on single case reports. Based on the existing literature, open surgery appears to be the only curative approach, although complications are not uncommon.
As in the present case, an open abdomen may be required as a result of such complex and also emergency abdominal procedures to prevent pathologic pressures and secondary organ damage. In addition to the expected prolonged length of stay, there are further complications such as the risk of enteric fistulas, infections, wound complications, and pneumonia with prolonged artificial ventilation. In the present case of a 16-year-old patient, the psychological consequences of an open abdomen were added as a serious limitation to quality of life. Alternative treatment concepts include the use of negative pressure therapies and mesh covers, as also described in the present case. While purely horizontal traction of the fascial edges on each other might have caused a relevant increase in intra-abdominal pressure (IAP), vertical traction might be associated with a lower pressure load. Focusing on aortic procedures, a multicenter study showed a relevant rate of serious secondary complications resulting from open abdomen: in addition to enteric fistulas, delayed prosthetic infections occurring in the hospital and intestinal ischemia were described, independent of the type of care but depending on the duration of the presence of the open abdomen. Similar results are suggested by the multicenter International Registry of Open Abdomen (IROA): after evaluation of 649 patients, an association between intestinal fistulas and the duration of presence of the open abdomen was shown.
In the present case, despite complex, prior emergency surgery, the open abdomen was completely closed in all layers within three operations over 6 days after the start of fasciotens® use. No abdominal discomfort or early incisional herniation was seen in the further course. In our opinion fasciotens®Abdomen thus represents a useful addition to the armamentarium of abdominal surgeons, even though prospective, possibly even randomized studies are lacking to scientifically substantiate the success of the therapy.
Gefässchirurgie 26, 56–60 (2021), A. Gombert, R. Eickhoff, P. Doukas, D. Kotelis & M. J. Jacobs
DOI https://doi.org/10.1007/s00772-020-00707-3
Case Report: Prevention of fascial retraction in the open abdomen and awake patients
Case report: The use of direct, controlled fascial traction of 50-60 Newtons, prevented fascial retraction in open abdomen. Once the oedema subsided, the abdomen could be closed without problems. This new form of therapy was well tolerated by the patient and allowed significantly faster closure without mesh or abdominal wall reconstruction.
Fascia stretching for abdominal closure … After perforated abdominal aortic aneurysm – A new therapeutic option
The case presented in “Chirurgische Allgemeine” describes successful abdominal closure using fasciotens abdomen. Fascia stretching for abdominal closure after perforated abdominal aortic aneurysm. Chirurgische Allgemeine – Offprint. Fascial stretching for abdominal closure after perforated abdominal aortic aneurysm. CHAZ 4_2020 April 2020.
Case Report of the University Hospital Düsseldorf
The University Hospital Düsseldorf has published a case report on the use of Fasciotens®Abdomen ICU: “Novel Device Prevents Abdominal Wall Retraction and Facilitates Early Abdominal Wall Closure of Septic Open Abdomen”.Lupine Publishers, Surgery & Case Studies: Open Access Journal, ISSN: 2643-6760 / DOI: 10.32474/SCSOAJ.2019.04.000177, 11 December 2019.
One year of fasciotens – what users report
A year ago we already reported on the two surgeons Dr Gereon Lill and Dr Frank Beyer, who have made a virtue out of a necessity. They have launched a new product to fundamentally improve the medical care of the open abdomen. A rocky road that is slowly but surely bearing fruit. One year after the market launch of fasciotens®Abdomen, we asked users about their experiences. BDC. One year of Fasciotens – what users report. Passion Surgery. 2019 December, 9(12): Article 03_02. Further articles on this topic can be found on BDC|Online (www.bdc.de, category Knowledge | Specialties | Visceral Surgery).
Abdominal wall under tension
Report in “Medical Technology & Digital Health: “Case Study fasciotens® GmbH: Therapy of the open abdomen”Platform LifeSciences. Abdominal wall under tension. Medical Technology & Digital Health. 2019 November (Issue No. 4):. Page 43.